1
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Pollock C, Moon JY, Ngoc Ha LP, Gojaseni P, Ching CH, Gomez L, Chan TM, Wu MJ, Yeo SC, Nugroho P, Bhalla AK. Framework of Guidelines for Management of CKD in Asia. Kidney Int Rep 2024; 9:752-790. [PMID: 38765566 PMCID: PMC11101746 DOI: 10.1016/j.ekir.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/29/2023] [Accepted: 12/11/2023] [Indexed: 05/22/2024] Open
Affiliation(s)
- Carol Pollock
- Kolling Institute of Medical Research, University of Sydney, St Leonards, New South Wales, Australia
| | - Ju-young Moon
- Kyung Hee University School of Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea
| | - Le Pham Ngoc Ha
- University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam
| | | | | | - Lynn Gomez
- Asian Hospital and Medical Center, Muntinlupa City, Metro Manila, Philippines
| | - Tak Mao Chan
- Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong
| | - Ming-Ju Wu
- Taichung Veterans General Hospital, Taichung City, Taiwan
| | | | | | - Anil Kumar Bhalla
- Department of Nephrology-Sir Ganga Ram Hospital Marg, New Delhi, Delhi, India
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Aparcana-Granda DJ, Ascencio EJ, Carrillo Larco RM. Systematic review of diagnostic and prognostic models of chronic kidney disease in low-income and middle-income countries. BMJ Open 2022; 12:e058921. [PMID: 35292503 PMCID: PMC8928240 DOI: 10.1136/bmjopen-2021-058921] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
OBJECTIVE To summarise available chronic kidney disease (CKD) diagnostic and prognostic models in low-income and middle-income countries (LMICs). METHOD Systematic review (Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines). We searched Medline, EMBASE, Global Health (these three through OVID), Scopus and Web of Science from inception to 9 April 2021, 17 April 2021 and 18 April 2021, respectively. We first screened titles and abstracts, and then studied in detail the selected reports; both phases were conducted by two reviewers independently. We followed the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies recommendations and used the Prediction model Risk Of Bias ASsessment Tool for risk of bias assessment. RESULTS The search retrieved 14 845 results, 11 reports were studied in detail and 9 (n=61 134) were included in the qualitative analysis. The proportion of women in the study population varied between 24.5% and 76.6%, and the mean age ranged between 41.8 and 57.7 years. Prevalence of undiagnosed CKD ranged between 1.1% and 29.7%. Age, diabetes mellitus and sex were the most common predictors in the diagnostic and prognostic models. Outcome definition varied greatly, mostly consisting of urinary albumin-to-creatinine ratio and estimated glomerular filtration rate. The highest performance metric was the negative predictive value. All studies exhibited high risk of bias, and some had methodological limitations. CONCLUSION There is no strong evidence to support the use of a CKD diagnostic or prognostic model throughout LMIC. The development, validation and implementation of risk scores must be a research and public health priority in LMIC to enhance CKD screening to improve timely diagnosis.
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Affiliation(s)
- Diego J Aparcana-Granda
- School of Medicine 'Alberto Hurtado', Universidad Peruana Cayetano Heredia, Lima, Peru
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Edson J Ascencio
- School of Medicine 'Alberto Hurtado', Universidad Peruana Cayetano Heredia, Lima, Peru
- Health Innovation Laboratory, Institute of Tropical Medicine 'Alexander von Humboldt', Universidad Peruana Cayetano Heredia, Lima, Peru
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Rodrigo M Carrillo Larco
- CRONICAS Centre of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
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3
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Yang X, Zhou B, Zhou L, Cui L, Zeng J, Wang S, Shi W, Zhang Y, Luo X, Xu C, Xue Y, Chen H, Chen S, Wang G, Guo L, Jose PA, Wilcox CS, Wu S, Wu G, Zeng C. Development and Validation of Prediction Models for Hypertensive Nephropathy, the PANDORA Study. Front Cardiovasc Med 2022; 9:794768. [PMID: 35360013 PMCID: PMC8960139 DOI: 10.3389/fcvm.2022.794768] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 02/17/2022] [Indexed: 11/13/2022] Open
Abstract
ImportanceHypertension is a leading cause of end-stage renal disease (ESRD), but currently, those at risk are poorly identified.ObjectiveTo develop and validate a prediction model for the development of hypertensive nephropathy (HN).Design, Setting, and ParticipantsIndividual data of cohorts of hypertensive patients from Kailuan, China served to derive and validate a multivariable prediction model of HN from 12, 656 individuals enrolled from January 2006 to August 2007, with a median follow-up of 6.5 years. The developed model was subsequently tested in both derivation and external validation cohorts.VariablesDemographics, physical examination, laboratory, and comorbidity variables.Main Outcomes and MeasuresHypertensive nephropathy was defined as hypertension with an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or proteinuria.ResultsAbout 8.5% of patients in the derivation cohort developed HN after a median follow-up of 6.5 years that was similar in the validation cohort. Eight variables in the derivation cohort were found to contribute to the risk of HN: salt intake, diabetes mellitus, stroke, serum low-density lipoprotein, pulse pressure, age, hypertension duration, and serum uric acid. The discrimination by concordance statistics (C-statistics) was 0.785 (IQR, 0.770-0.800); the calibration slope was 1.129, the intercept was –0.117; and the overall accuracy by adjusted R2 was 0.998 with similar results in the validation cohort. A simple points scale developed from these data (0, low to 40, high) detected a low morbidity of 7% in the low-risk group (0–10 points) compared with >40% in the high-risk group (>20 points).Conclusions and RelevanceA prediction model of HN over 8 years had high discrimination and calibration, but this model requires prospective evaluation in other cohorts, to confirm its potential to improve patient care.
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Affiliation(s)
- Xiaoli Yang
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Bingqing Zhou
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Li Zhou
- Department of Epidemiology, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Liufu Cui
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Jing Zeng
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Shuo Wang
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Weibin Shi
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Ye Zhang
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Xiaoli Luo
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Chunmei Xu
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Yuanzheng Xue
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
| | - Hao Chen
- Department of Epidemiology, School of Public Health and Management, Chongqing Medical University, Chongqing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Guodong Wang
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Li Guo
- Department of Endocrinology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Pedro A. Jose
- Division of Renal Disease & Hypertension, The George Washington University School of Medicine & Health Sciences, Washington, DC, United States
| | - Christopher S. Wilcox
- Division of Nephrology and Hypertension, Department of Medicine and Center for Hypertension, Kidney and Vascular Health, Georgetown University, Washington, DC, United States
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
- *Correspondence: Shouling Wu,
| | - Gengze Wu
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
- Gengze Wu,
| | - Chunyu Zeng
- Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China
- Chongqing Key Laboratory for Hypertension Research, Chongqing Cardiovascular Clinical Research Center, Chongqing Institute of Cardiology, Chongqing, China
- State Key Laboratory of Trauma, Burns and Combined Injury, Daping Hospital, The Third Military Medical University, Chongqing, China
- Cardiovascular Research Center of Chongqing College, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Chongqing, China
- Chunyu Zeng,
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4
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Evaluation of Serum Cyclooxygenase, Hepcidin Levels in Acute Renal Injury (AKI) Patients Following Cardiac Catheterization. Rep Biochem Mol Biol 2021; 10:197-203. [PMID: 34604409 DOI: 10.52547/rbmb.10.2.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Accepted: 02/08/2021] [Indexed: 11/18/2022]
Abstract
Background Acute kidney damage is a severe condition common in patients who have undergone heart surgery (catheterization) and secondary injury is also referred to as being synonymous with surgery. The goal of this research is to determine the rate of cyclooxygenase and hepcidin levels in patients with acute renal injury (AKI) following cardiac catheterization. Methods The study is performed on (81) patients (64 males and 17 females) aged 40-75 years. Data from most patients are reported in the form of age, gender, and smoking background questionnaire. Results The results indicate a significant increase in serum levels of cyclooxygenase and hepcidin levels in patients with severe renal insufficiency after cardiac catheterization by (79%) males versus (21%) females. Conclusion In this study, improved risk prediction could enhance patient monitoring and treatment after surgery, direct patient treatment and decision making, and enhance participation in AKI interventional trials.
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5
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney health for everyone everywhere: from prevention to detection and equitable access to care. J Nephrol 2021; 33:201-210. [PMID: 32232774 DOI: 10.1007/s40620-020-00728-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions-be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China.
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jal., Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China
| | - Anne Hradsky
- World Kidney Day Office, Avenue des Arts 1-2, 6th floor, 1210, Brussels, Belgium
| | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ziyoda Rakhimova
- World Kidney Day Office, Avenue des Arts 1-2, 6th floor, 1210, Brussels, Belgium
| | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Luisa Strani
- World Kidney Day Office, Avenue des Arts 1-2, 6th floor, 1210, Brussels, Belgium
| | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA, USA.
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Iseki K, Konta T, Asahi K, Yamagata K, Fujimoto S, Tsuruya K, Narita I, Kasahara M, Shibagaki Y, Moriyama T, Kondo M, Iseki C, Watanabe T. Impact of Metabolic Syndrome on the Mortality Rate among Participants in a Specific Health Check and Guidance Program in Japan. Intern Med 2020; 59:2671-2678. [PMID: 32669499 PMCID: PMC7691040 DOI: 10.2169/internalmedicine.4975-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Objective In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) program was started in 2008 to decrease the social burden related to metabolic syndrome (MetS). However, so far this program has not been found to have any impact on the mortality rate. Methods The subjects consisted of individuals who participated in the Tokutei-Kenshin in seven districts between 2008 and 2015. Using a National database of death certificates, we identified those who might have died and then further confirmed such deaths with the collaboration of the regional National Health Insurance agency and public health nurses. The diagnosis of MetS was made according to the Japanese criteria. The causes of death were classified by ICD-10. Mortality risk was evaluated after adjusting for age, sex, smoking, alcohol intake and past medical history such as stroke, heart disease and kidney disease. Results Among the total of 664,926 subjects, we identified 8,051 fatal cases by the end of 2015. The crude death rate was 1.6% for those with MetS, 1.3% for those with preliminary metabolic syndrome, and 1.1% those without MetS. In MetS, the adjusted hazard ratio (95% confidence interval) was 1.08 (1.02-1.15) for all-cause and 1.39 (1.22-1.58) for cardiovascular disease mortality when the reference was for those without MetS. Conclusion The death rate was found to be significantly higher among the participants with MetS.
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Affiliation(s)
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University School of Medicine, Japan
| | - Koichi Asahi
- Division of Nephrology and Hypertension, Iwate Medical University, Japan
| | - Kunihiro Yamagata
- Division of Nephrology, Faculty of Medicine, Tsukuba University, Japan
| | - Shouichi Fujimoto
- Department of Hemovascular Medicine and Artificial Organs, Faculty of Medicine, University of Miyazaki, Japan
| | | | - Ichiei Narita
- Division of Nephrology and Rheumatology, Kidney Research Center, Niigata University Graduate School of Medicine and Dental Sciences, Japan
| | - Masato Kasahara
- Institute for Clinical and Translational Science, Nara Medical University Hospital, Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine, Japan
| | | | - Masahide Kondo
- Graduate School of Comprehensive Human Science, University of Tsukuba, Japan
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7
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Sumida K, Nadkarni GN, Grams ME, Sang Y, Ballew SH, Coresh J, Matsushita K, Surapaneni A, Brunskill N, Chadban SJ, Chang AR, Cirillo M, Daratha KB, Gansevoort RT, Garg AX, Iacoviello L, Kayama T, Konta T, Kovesdy CP, Lash J, Lee BJ, Major RW, Metzger M, Miura K, Naimark DMJ, Nelson RG, Sawhney S, Stempniewicz N, Tang M, Townsend RR, Traynor JP, Valdivielso JM, Wetzels J, Polkinghorne KR, Heerspink HJL. Conversion of Urine Protein-Creatinine Ratio or Urine Dipstick Protein to Urine Albumin-Creatinine Ratio for Use in Chronic Kidney Disease Screening and Prognosis : An Individual Participant-Based Meta-analysis. Ann Intern Med 2020; 173:426-435. [PMID: 32658569 PMCID: PMC7780415 DOI: 10.7326/m20-0529] [Citation(s) in RCA: 148] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Although measuring albuminuria is the preferred method for defining and staging chronic kidney disease (CKD), total urine protein or dipstick protein is often measured instead. OBJECTIVE To develop equations for converting urine protein-creatinine ratio (PCR) and dipstick protein to urine albumin-creatinine ratio (ACR) and to test their diagnostic accuracy in CKD screening and staging. DESIGN Individual participant-based meta-analysis. SETTING 12 research and 21 clinical cohorts. PARTICIPANTS 919 383 adults with same-day measures of ACR and PCR or dipstick protein. MEASUREMENTS Equations to convert urine PCR and dipstick protein to ACR were developed and tested for purposes of CKD screening (ACR ≥30 mg/g) and staging (stage A2: ACR of 30 to 299 mg/g; stage A3: ACR ≥300 mg/g). RESULTS Median ACR was 14 mg/g (25th to 75th percentile of cohorts, 5 to 25 mg/g). The association between PCR and ACR was inconsistent for PCR values less than 50 mg/g. For higher PCR values, the PCR conversion equations demonstrated moderate sensitivity (91%, 75%, and 87%) and specificity (87%, 89%, and 98%) for screening (ACR >30 mg/g) and classification into stages A2 and A3, respectively. Urine dipstick categories of trace or greater, trace to +, and ++ for screening for ACR values greater than 30 mg/g and classification into stages A2 and A3, respectively, had moderate sensitivity (62%, 36%, and 78%) and high specificity (88%, 88%, and 98%). For individual risk prediction, the estimated 2-year 4-variable kidney failure risk equation using predicted ACR from PCR had discrimination similar to that of using observed ACR. LIMITATION Diverse methods of ACR and PCR quantification were used; measurements were not always performed in the same urine sample. CONCLUSION Urine ACR is the preferred measure of albuminuria; however, if ACR is not available, predicted ACR from PCR or urine dipstick protein may help in CKD screening, staging, and prognosis. PRIMARY FUNDING SOURCE National Institute of Diabetes and Digestive and Kidney Diseases and National Kidney Foundation.
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Affiliation(s)
- Keiichi Sumida
- University of Tennessee Health Science Center, Memphis, Tennessee (K.S.)
| | - Girish N Nadkarni
- Icahn School of Medicine at Mount Sinai, New York, New York (G.N.N.)
| | - Morgan E Grams
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Yingying Sang
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Shoshana H Ballew
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Kunihiro Matsushita
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Aditya Surapaneni
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (M.E.G., Y.S., S.H.B., J.C., K.M., A.S.)
| | - Nigel Brunskill
- Leicester General Hospital, University Hospitals of Leicester NHS Trust, and University of Leicester, Leicester, United Kingdom (N.B., R.W.M.)
| | - Steve J Chadban
- Royal Prince Alfred Hospital and Kidney Node, University of Sydney, Sydney, New South Wales, Australia (S.J.C.)
| | - Alex R Chang
- Geisinger Health, Danville, Pennsylvania (A.R.C.)
| | | | - Kenn B Daratha
- Providence Sacred Heart Medical Center and Gonzaga University School of Anesthesia, Spokane, Washington (K.B.D.)
| | - Ron T Gansevoort
- University Medical Center Groningen, University of Groningen, Groningen, the Netherlands (R.T.G.)
| | - Amit X Garg
- ICES and Western University, London, Ontario, Canada (A.X.G.)
| | - Licia Iacoviello
- IRCCS Neuromed, Pozzilli, Italy, and University of Insubria, Varese, Italy (L.I.)
| | | | - Tsuneo Konta
- Yamagata University, Yamagata, Japan (T.K., T.K.)
| | - Csaba P Kovesdy
- Memphis Veterans Affairs Medical Center and University of Tennessee Health Science Center, Memphis, Tennessee (C.P.K.)
| | - James Lash
- University of Illinois at Chicago, Chicago, Illinois (J.L.)
| | - Brian J Lee
- Kaiser Permanente, Hawaii Region, and Moanalua Medical Center, Honolulu, Hawaii (B.J.L.)
| | - Rupert W Major
- Leicester General Hospital, University Hospitals of Leicester NHS Trust, and University of Leicester, Leicester, United Kingdom (N.B., R.W.M.)
| | - Marie Metzger
- Paris Saclay University, Paris-Sud University, UVSQ, CESP, INSERM U1018, Villejuif, France (M.M.)
| | - Katsuyuki Miura
- Shiga University of Medical Science Seta-Tsukinowa-cho, Shiga, Japan (K.M.)
| | - David M J Naimark
- Sunnybrook Hospital, University of Toronto, Toronto, Ontario, Canada (D.M.N.)
| | - Robert G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Phoenix, Arizona (R.G.N.)
| | | | | | - Mila Tang
- University of British Columbia, Vancouver, British Columbia, Canada (M.T.)
| | - Raymond R Townsend
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (R.R.T.)
| | - Jamie P Traynor
- Queen Elizabeth University Hospital, Glasgow, Scotland (J.P.T.)
| | - José M Valdivielso
- Institute of Biomedical Research of Lleida and Spanish Research Network for Renal Diseases, Lleida, Spain (J.M.V.)
| | - Jack Wetzels
- Radboud University Medical Center, Nijmegen, the Netherlands (J.W.)
| | | | - Hiddo J L Heerspink
- University of Groningen, University Medical Center, Groningen, the Netherlands, and The George Institute for Global Health, Sydney, New South Wales, Australia (H.J.H.)
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8
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Sui Z, Wang J, Cabrera C, Wei J, Wang M, Zuo L. Aetiology of chronic kidney disease and risk factors for disease progression in Chinese subjects: A single-centre retrospective study in Beijing. Nephrology (Carlton) 2020; 25:714-722. [PMID: 32180286 PMCID: PMC7496201 DOI: 10.1111/nep.13714] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 02/20/2020] [Accepted: 03/01/2020] [Indexed: 12/17/2022]
Abstract
AIM To assess the aetiological factors of chronic kidney disease (CKD) and factors associated with disease progression. METHODS Single-centre retrospective study evaluating thorough electronic medical records of patients diagnosed with CKD at Peking University People's Hospital (April 2010-April 2015). The objectives were to identify the aetiological factors of CKD in Chinese patients and risk factors associated with CKD progression. RESULTS Of 15 425 CKD patients, 12 380 had aetiology recorded. The leading aetiologies associated with CKD were chronic glomerulonephritis (CGN; 36.8%), hypertensive nephropathy (HTN; 28.5%) and diabetic nephropathy (DN; 27.1%). CGN was most common in patients with early stage disease (stages 1-2); DN and HTN were common in advanced-stages (stages 3-4). In a longitudinal subcohort of 2923 patients with ≥6-month follow-up, 19.6% experienced CKD progression. Patients with CKD progression were significantly older in age and had a greater number of comorbidities and laboratory anomalies, and were more likely to have DN (40.5%) and CGN (40.5%) than HTN (5.5%) at baseline than patients without progression. In a multivariate analysis, factors associated with disease progression included macro- and micro-albuminuria, anaemia, hyperkalaemia, hyperphosphataemia, metabolic acidosis, CKD stage 4 and type 2 diabetes mellitus (T2DM). CONCLUSION This study identified CGN, DN and HTN as the leading aetiological factors for CKD in Chinese patients. DN was a strong predictor of faster disease progression, with albuminuria (a complication of T2DM) associated with highest risk for disease progression.
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Affiliation(s)
- Zhun Sui
- Department of NephrologyPeking University People's HospitalBeijingChina
| | - Jiemin Wang
- AstraZeneca Global R&D InformationShanghaiChina
| | - Claudia Cabrera
- AstraZeneca R&DGothenburgSweden
- Department of Medical Epidemiology and BiostatisticsKarolinska InstituteStockholmSweden
| | - Jia Wei
- AstraZeneca Global R&D InformationShanghaiChina
| | - Mi Wang
- Department of NephrologyPeking University People's HospitalBeijingChina
| | - Li Zuo
- Department of NephrologyPeking University People's HospitalBeijingChina
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9
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Saminathan TA, Hooi LS, Mohd Yusoff MF, Ong LM, Bavanandan S, Rodzlan Hasani WS, Tan EZZ, Wong I, Rifin HM, Robert TG, Ismail H, Wong NI, Ahmad G, Ambak R, Othman F, Abd Hamid HA, Aris T. Prevalence of chronic kidney disease and its associated factors in Malaysia; findings from a nationwide population-based cross-sectional study. BMC Nephrol 2020; 21:344. [PMID: 32795256 PMCID: PMC7427283 DOI: 10.1186/s12882-020-01966-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/20/2020] [Indexed: 01/08/2023] Open
Abstract
Background The prevalence of chronic kidney disease (CKD) in Malaysia was 9.07% in 2011. We aim to determine the current CKD prevalence in Malaysia and its associated risk factors. Methods A population-based study was conducted on a total of 890 respondents who were representative of the adult population in Malaysia, i.e., aged ≥18 years old. Respondents were randomly selected using a stratified cluster method. The estimated glomerular filtration rate (eGFR) was estimated from calibrated serum creatinine using the CKD-EPI equation. CKD was defined as eGFR < 60 ml/min/1.73m2 or the presence of persistent albuminuria if eGFR ≥60 ml/min/1.73m2. Results Our study shows that the prevalence of CKD in Malaysia was 15.48% (95% CI: 12.30, 19.31) in 2018, an increase compared to the year 2011 when the prevalence of CKD was 9.07%. An estimated 3.85% had stage 1 CKD, 4.82% had stage 2 CKD, and 6.48% had stage 3 CKD, while 0.33% had stage 4–5 CKD. Hypertension (aOR 3.72), diabetes mellitus (aOR 3.32), increasing BMI (aOR 1.06), and increasing age (aOR 1.06) were significantly associated with CKD. Conclusion Our study has shown that CKD has become one of the leading public health issues in Malaysia. Thus, there is an urgent need to screen for CKD and prevent its progression, associated morbidity, and mortality at the national level.
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Affiliation(s)
- Thamil Arasu Saminathan
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia.
| | - Lai Seong Hooi
- Sultanah Aminah Hospital, Ministry of Health Malaysia, Johor Bahru, Johor, Malaysia
| | - Muhammad Fadhli Mohd Yusoff
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Loke Meng Ong
- Clinical Research Centre Penang Hospital, Ministry of Health Malaysia, George Town, Penang, Malaysia
| | - Sunita Bavanandan
- Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Wan Shakira Rodzlan Hasani
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Esther Zhao Zhi Tan
- Selayang Hospital, Ministry of Health Malaysia, Batu Caves, Selangor, Malaysia
| | - Irene Wong
- Tengku Ampuan Rahimah Hospital, Ministry of Health Malaysia, Klang, Selangor, Malaysia
| | - Halizah Mat Rifin
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Tania Gayle Robert
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Hasimah Ismail
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Norazizah Ibrahim Wong
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Ghazali Ahmad
- Kuala Lumpur Hospital, Ministry of Health Malaysia, Kuala Lumpur, Malaysia
| | - Rashidah Ambak
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Fatimah Othman
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Hamizatul Akmal Abd Hamid
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
| | - Tahir Aris
- Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia
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10
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere-From Prevention to Detection and Equitable Access to Care. Kidney Med 2020; 2:5-11. [PMID: 32734223 PMCID: PMC7380375 DOI: 10.1016/j.xkme.2020.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
- Address for Correspondence: Philip Kam-Tao Li, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China.
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA
- Kamyar Kalantar-Zadeh, Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, 333 City Boulevard West, Suite 400, Orange, CA 92868
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11
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Kam-Tao Li P, Garcia-Garcia G, Lui S, Andreoli S, Wing-Shing Fung W, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. [Kidney health for everyone everywhere - from prevention to detection and equitable access to care]. TERAPEVT ARKH 2020; 92:4-14. [PMID: 33346487 DOI: 10.26442/00403660.2020.06.000545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Indexed: 11/22/2022]
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can beimplemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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Affiliation(s)
| | | | - S Lui
- The Chinese University of Hong Kong
| | | | | | | | | | - V Liakopoulos
- AHEPA Hospital, Aristotle University of Thessaloniki
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12
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere - From Prevention to Detection and Equitable Access to Care. KIDNEY DISEASES 2020; 6:136-143. [PMID: 32523955 DOI: 10.1159/000506528] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 02/12/2020] [Indexed: 12/29/2022]
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions - be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, California, USA
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13
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere: From Prevention to Detection and Equitable Access to Care. Can J Kidney Health Dis 2020; 7:2054358120910569. [PMID: 32215213 PMCID: PMC7066467 DOI: 10.1177/2054358120910569] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 02/10/2020] [Indexed: 12/01/2022] Open
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the fifth most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual health care budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions—be it primary, secondary, or tertiary. This article complements this initiative by focusing on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with preexisting kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of comorbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to disseminate the preventive approach. While national policies and strategies for noncommunicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management, and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals, and policy makers.
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Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, USA
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14
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney health for everyone everywhere - from prevention to detection and equitable access to care. ACTA ACUST UNITED AC 2020; 53:e9614. [PMID: 32159613 PMCID: PMC7076785 DOI: 10.1590/1414-431x20209614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 01/08/2020] [Indexed: 11/22/2022]
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a
projection of becoming the 5th most common cause of years of life lost globally
by 2040. CKD is a major cause of catastrophic health expenditure. The costs of
dialysis and transplantation consume up to 3% of the annual healthcare budget in
high-income countries. However, the onset and progression of CKD is often
preventable. In 2020, the World Kidney Day campaign highlights the importance of
preventive interventions – be it primary, secondary, or tertiary. This article
focuses on outlining and analyzing measures that can be implemented in every
country to promote and advance CKD prevention. Primary prevention of kidney
disease should focus on the modification of risk factors and addressing
structural abnormalities of the kidney and urinary tracts, as well as exposure
to environmental risk factors and nephrotoxins. In persons with pre-existing
kidney disease, secondary prevention, including blood pressure optimization and
glycemic control, should be the main goal of education and clinical
interventions. In patients with advanced CKD, management of co-morbidities such
as uremia and cardiovascular disease is a highly recommended preventative
intervention to avoid or delay dialysis or kidney transplantation. Political
efforts are needed to proliferate the preventive approach. While national
policies and strategies for non-communicable diseases might be present in a
country, specific policies directed toward education and awareness about CKD
screening, management, and treatment are often lacking. Hence, there is an
urgent need to increase the awareness of preventive measures throughout
populations, professionals, and policy makers.
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Affiliation(s)
- P Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - G Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - S Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, USA
| | - W Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - A Hradsky
- World Kidney Day Office, Brussels, Belgium
| | | | - V Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - G Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - L Strani
- World Kidney Day Office, Brussels, Belgium
| | - I Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - K Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA, USA
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15
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere-From Prevention to Detection and Equitable Access to Care. Kidney Int Rep 2020; 5:245-251. [PMID: 32154446 PMCID: PMC7056846 DOI: 10.1016/j.ekir.2020.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, California, USA
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16
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere - From Prevention to Detection and Equitable Access to Care. Indian J Nephrol 2020; 30:63-71. [PMID: 32269428 PMCID: PMC7132858 DOI: 10.4103/ijn.ijn_50_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/05/2020] [Indexed: 12/29/2022] Open
Abstract
The global burden of chronic kidney disease (CKD) is rapidly increasing with a projection of becoming the 5th most common cause of years of life lost globally by 2040. Aggravatingly, CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the annual healthcare budget in high-income countries. Crucially, however, the onset and progression of CKD is often preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions – be it primary, secondary or tertiary. This complementing article focuses on outlining and analyzing measures that can be implemented in every country to promote and advance CKD prevention. Primary prevention of kidney disease should focus on the modification of risk factors and addressing structural abnormalities of the kidney and urinary tracts, as well as exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization and glycemic control, should be the main goal of education and clinical interventions. In patients with advanced CKD, management of co-morbidities such as uremia and cardiovascular disease is a highly recommended preventative intervention to avoid or delay dialysis or kidney transplantation. Political efforts are needed to proliferate the preventive approach. While national policies and strategies for non-communicable diseases might be present in a country, specific policies directed toward education and awareness about CKD screening, management and treatment are often lacking. Hence, there is an urgent need to increase the awareness of the importance of preventive measures throughout populations, professionals and policy makers.
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Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jal., Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol and Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China
| | - Anne Hradsky
- World Kidney Day Office, Avenue des Arts 1-2, 6th Floor, B-1210, Brussels, Belgium
| | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ziyoda Rakhimova
- World Kidney Day Office, Avenue des Arts 1-2, 6th Floor, B-1210, Brussels, Belgium
| | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | - Luisa Strani
- World Kidney Day Office, Avenue des Arts 1-2, 6th Floor, B-1210, Brussels, Belgium
| | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, CA, USA
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17
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney health for everyone everywhere-From prevention to detection and equitable access to care. Nephrology (Carlton) 2020; 25:195-201. [PMID: 32061145 DOI: 10.1111/nep.13695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/16/2020] [Accepted: 01/21/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Philip K-T Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana
| | - Winston W-S Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, First Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, California
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- Members of the World Kidney Day Steering Committee are listed in the Appendix
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18
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney Health for Everyone Everywhere-From Prevention to Detection and Equitable Access to Care. J Ren Care 2020; 46:4-12. [PMID: 32052938 DOI: 10.1111/jorc.12316] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The global burden of chronic kidney disease (CKD) is increasing with a projection of becoming the fifth leading cause of years of life lost globally by 2040. CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the entire annual healthcare budget in high-income countries. Crucially, however, both the onset and progression of CKD is potentially preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions-be it primary, i.e. to prevent de novo CKD, or secondary or tertiary, i.e. prevention of worsening early CKD or progression of more advanced CKD to end-stage kidney disease, respectively. Primary prevention should focus on the modification of CKD risk factors and address the structural abnormalities of the kidney and urinary tracts, and exposure to environmental risk factors and nephrotoxins. In persons with pre-existing kidney disease, secondary prevention, including blood pressure optimization, glycemic control and avoiding high-protein high-sodium diet should be the main goal of education and clinical interventions. In patients with moderate to advanced CKD, the management of comorbidities such as uremia and cardiovascular disease along with low-protein diet are among the recommended preventative interventions to avoid or delay dialysis or kidney transplantation. Whereas national policies and strategies for noncommunicable diseases may exist in a country, specific policies directed toward education and awareness about CKD screening, prevention and treatment are often lacking. There is an urgent need to increase awareness for preventive measures throughout populations, professionals and policy makers.
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Affiliation(s)
- Philip Kam-Tao Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, University of Guadalajara Health Sciences Center, Guadalajara, Jalisco, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Sharon Andreoli
- James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Winston Wing-Shing Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, 1st Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Ituku-Ozalla, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, University of California Irvine School of Medicine, Orange, California, USA
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Li PKT, Garcia-Garcia G, Lui SF, Andreoli S, Fung WWS, Hradsky A, Kumaraswami L, Liakopoulos V, Rakhimova Z, Saadi G, Strani L, Ulasi I, Kalantar-Zadeh K. Kidney health for everyone, everywhere: from prevention to detection and equitable access to care. Intern Med J 2020; 50:145-150. [PMID: 32037701 DOI: 10.1111/imj.14736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 12/13/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Philip K-T Li
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - Guillermo Garcia-Garcia
- Nephrology Service, Hospital Civil de Guadalajara Fray Antonio Alcalde, Health Sciences Center, University of Guadalajara, Guadalajara, Mexico
| | - Siu-Fai Lui
- Division of Health System, Policy and Management, Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
| | - Sharon Andreoli
- Division of Pediatric Nephrology, James Whitcomb Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Winston W-S Fung
- Department of Medicine and Therapeutics, Carol & Richard Yu PD Research Centre, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | | | | | - Vassilios Liakopoulos
- Division of Nephrology and Hypertension, Department of Internal Medicine, AHEPA Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Gamal Saadi
- Nephrology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt
| | | | - Ifeoma Ulasi
- Renal Unit, Department of Medicine, College of Medicine, University of Nigeria, Enugu, Nigeria
| | - Kamyar Kalantar-Zadeh
- Division of Nephrology and Hypertension and Kidney Transplantation, Irvine School of Medicine, University of California, Orange, California, USA
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Mortality risk among screened subjects of the specific health check and guidance program in Japan 2008-2012. Clin Exp Nephrol 2017; 21:978-985. [PMID: 28258498 DOI: 10.1007/s10157-017-1392-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2017] [Accepted: 02/09/2017] [Indexed: 10/20/2022]
Abstract
BACKGROUND In Japan, the Specific Health Check and Guidance (Tokutei-Kenshin) has started in 2008. However, the relationship between the baseline characteristics and mortality has not been examined. METHODS Subjects were those who participated at the 2008 Tokutei-Kenshin in six districts with baseline data of serum creatinine. Using National database of death certificate from 2008 to 2012, we identified those who might have died and confirmed further with the collaborations of the regional National Health Insurance agency and public health nurses. The data was released to the research team supported by the Ministry of Health, Labor, and Welfare of Japan, and is governed by strict regulation and is completely encrypted with the individual's name and residence. Causes of death were classified by ICD-10. RESULTS Among the total of 295,297 subjects, we identified 3764 fatal cases by end of 2012. The median BMI was 23.8 kg/m2 in men and 22.5 kg/m2 in women, respectively. Proteinuria, dipstick 1+ and over, was positive in 5.3%. The median eGFR was 73.8 ml/min/1.73 m2 among those with data available in 81% of the total cohort (N = 239,274). The leading cause of death was neoplasm in both genders. It was 51.6% of the total, 50.4% in men and 53.7% in women. The second cause of death was circulatory; 20.4% of the total, 21.1% in men and 19.2% in women. CONCLUSION Half of the causes of death was related to neoplasm among the cohort of the Tokutei-Kenshin. Effects of baseline demographics such as lifestyle and CKD remained to be studied.
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Sato K, Watanabe S, Ohtsubo A, Shoji S, Ishikawa D, Tanaka T, Nozaki K, Kondo R, Okajima M, Miura S, Tanaka J, Sakagami T, Koya T, Kagamu H, Yoshizawa H, Narita I. Nephrotoxicity of cisplatin combination chemotherapy in thoracic malignancy patients with CKD risk factors. BMC Cancer 2016; 16:222. [PMID: 26979596 PMCID: PMC4793503 DOI: 10.1186/s12885-016-2271-8] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 03/10/2016] [Indexed: 12/14/2022] Open
Abstract
Background Nephrotoxicity is the major side effect that limits the dose of cisplatin that can be safely administered, and it is a clinical problem in cancer patients who received cisplatin combination chemotherapy. Recent evidence has demonstrated that patients with chronic kidney disease (CKD) have an increased risk of developing acute kidney injury (AKI). The present study was conducted to evaluate the prevalence of CKD risk factors in patients who received cisplatin and to assess the correlation between CKD risk factors and cisplatin-induced AKI. Methods We retrospectively analyzed 84 patients treated with cisplatin combination chemotherapy for thoracic malignancies. AKI was defined as a decrease in the estimated glomerular filtration rate (eGFR) > 25 % from base line, an increase in the serum creatinine (sCre) level of > 0.3 mg/dl or ≥ 1.5 times the baseline level. Results Eighty of the 84 patients (95.2 %) had at least one risk factor for CKD. All enrolled patients received cisplatin with hydration, magnesium supplementation and mannitol. Cisplatin-induced AKI was observed in 18 patients (21.4 %). Univariate analysis revealed that cardiac disease and use of non-steroidal anti-inflammatory drugs (NSAIDs) were associated with cisplatin-induced nephrotoxicity (odds ratios [OR] 6 and 3.56, 95 % confidence intervals [CI] 1.21–29.87 and 1.11–11.39, p = 0.04 and p = 0.04, respectively). Multivariate analysis revealed that cisplatin nephrotoxicity occurred significantly more often in patients with both risk factors (OR 13.64, 95 % CI 1.11–326.83, p = 0.04). Patients with more risk factors for CKD tended to have a greater risk of developing cisplatin-induced AKI. Conclusions We should consider avoiding administration of cisplatin to patients with CKD risk factors, particularly cardiac disease and NSAID use. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2271-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ko Sato
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Satoshi Watanabe
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan.
| | - Aya Ohtsubo
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Satoshi Shoji
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Daisuke Ishikawa
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Tomohiro Tanaka
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Koichiro Nozaki
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Rie Kondo
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Masaaki Okajima
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Satoru Miura
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Junta Tanaka
- Department of Health Promotion Medicine, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Takuro Sakagami
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Toshiyuki Koya
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Hiroshi Kagamu
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Hirohisa Yoshizawa
- Bioscience Medical Research Center, Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
| | - Ichiei Narita
- Department of Medicine (II), Niigata University Medical and Dental Hospital, Niigata City, Niigata, Japan
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Abstract
Renal Registry was started by the Hospital Authority (HA) in Hong Kong in 1995.
It is an online system developed by HA. It collects all patients under care in
HA, which is about 90–95 % of all requiring renal replacement
therapy (RRT) in Hong Kong. The total number of patients treated increased from
3312 in 1996 to 8510 in 2013. In 2013, there were 3501 renal transplant, 1192
hemodialysis (HD) and 3817 peritoneal dialysis (PD) patients. In 2013, 1147 new
patients joined the RRT program, 49.6% of them suffered from diabetic
nephropathy. Glomerulonephritis and hypertension are the 2nd and 3rd most common
causes of RRT in Hong Kong. The median age was 59.1 years with male to female
ratio of 1.54 to 1. Hong Kong practices ‘PD first' policy and the
majority of the patients are on CAPD treatment. The ratio of PD to HD was
76.2% to 23.8%. Eighty-six percent of all PD patients are on CAPD;
the remaining 14% are on automated peritoneal dialysis (APD). Sixty-five
percent of all dialysis patients are on erythropoiesis-stimulating agent
treatment. The Hong Kong Renal Registry with online real-time data input and
access can provide timely data and information to facilitate patient care and
management and also provides invaluable data to help in development and planning
of renal services in Hong Kong.
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Lim CC, Teo BW, Tai ES, Lim SC, Chan CM, Sethi S, Wong TY, Sabanayagam C. Elevated serum leptin, adiponectin and leptin to adiponectin ratio is associated with chronic kidney disease in Asian adults. PLoS One 2015; 10:e0122009. [PMID: 25793395 PMCID: PMC4368742 DOI: 10.1371/journal.pone.0122009] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2015] [Accepted: 02/09/2015] [Indexed: 12/24/2022] Open
Abstract
Background Adiponectin and leptin, two of the key cytokines secreted by adipocytes, have been shown to be associated with cardiovascular disease. However, the association of these adipocytokines with chronic kidney disease (CKD) is not clear. We examined the association of serum adiponectin, leptin levels and leptin to adiponectin ratio (LAR) with CKD in a population-based sample of Asian adults. Methods We conducted a case-control study (450 CKD cases and 920 controls matched for age, sex and ethnicity) involving Chinese and Indian adults aged 40–80 years who participated in the Singapore Epidemiology of Eye Diseases Study (2007–2011). CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73m2 from serum creatinine. Serum adiponectin and leptin levels were measured using commercially available ELISA. Odds ratio of CKD associated with elevated adiponectin and leptin levels were estimated using logistic regression models adjusted for age, gender, ethnicity, education, smoking, body mass index, diabetes, blood pressure, total and HDL cholesterol. Results CKD cases had higher levels of leptin (mean [SD] 9.7 [11.5] vs.16.9 [20.2] ng/mL, p<0.0001) and adiponectin (10.4 [7.4] vs. 9.2 [4.2], p = 0.001) compared to controls. In multi-variable models, compared to those in the lowest quartile, the OR (95% confidence interval) of CKD among those in the highest quartile were: 6.46 (3.84, 10.88), 1.94 (1.32–2.85) and 2.88 (1.78–4.64) for leptin, adiponectin and LAR. Similar associations were also observed when adiponectin and leptin were analyzed as continuous variables. This positive association of serum adiponectin, leptin and LAR with CKD was consistently present in subgroups of gender, ethnicity, diabetes, hypertension and overweight status (all P-interaction >0.1). Conclusions Higher levels of serum adiponectin, leptin and LAR were positively associated with CKD independent of traditional risk factors in this Asian population.
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Affiliation(s)
- Cynthia Ciwei Lim
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Boon Wee Teo
- Department of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - E. Shyong Tai
- Department of Medicine, National University of Singapore, National University Health System, Singapore, Singapore
| | - Su Chi Lim
- Diabetes Centre, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Choong Meng Chan
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Sunil Sethi
- Department of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tien Y. Wong
- Singapore National Eye Center, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
| | - Charumathi Sabanayagam
- Ophthalmology and Visual Sciences Academic Clinical Program, Duke-NUS Graduate Medical School, National University of Singapore, Singapore, Singapore
- Singapore Eye Research Institute, Singapore, Singapore
- * E-mail:
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Abstract
Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.
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Affiliation(s)
- P K Tao Li
- Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong
| | - E A Burdmann
- Department of Medicine, University of Sao Paulo Medical School, Sao Paulo, SP, Brazil
| | - R L Mehta
- Department of Medicine, University of California San Diego, San Diego, CA, USA
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Modesti PA, Agostoni P, Agyemang C, Basu S, Benetos A, Cappuccio FP, Ceriello A, Del Prato S, Kalyesubula R, O’Brien E, Kilama MO, Perlini S, Picano E, Reboldi G, Remuzzi G, Stuckler D, Twagirumukiza M, Van Bortel LM, Watfa G, Zhao D, Parati G. Cardiovascular risk assessment in low-resource settings: a consensus document of the European Society of Hypertension Working Group on Hypertension and Cardiovascular Risk in Low Resource Settings. J Hypertens 2014; 32:951-60. [PMID: 24577410 PMCID: PMC3979828 DOI: 10.1097/hjh.0000000000000125] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2013] [Revised: 01/09/2014] [Accepted: 01/09/2014] [Indexed: 02/06/2023]
Abstract
The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 confirms ischemic heart disease and stroke as the leading cause of death and that hypertension is the main associated risk factor worldwide. How best to respond to the rising prevalence of hypertension in resource-deprived settings is a topic of ongoing public-health debate and discussion. In low-income and middle-income countries, socioeconomic inequality and cultural factors play a role both in the development of risk factors and in the access to care. In Europe, cultural barriers and poor communication between health systems and migrants may limit migrants from receiving appropriate prevention, diagnosis, and treatment. To use more efficiently resources available and to make treatment cost-effective at the patient level, cardiovascular risk approach is now recommended. In 2011, The European Society of Hypertension established a Working Group on 'Hypertension and Cardiovascular risk in low resource settings', which brought together cardiologists, diabetologists, nephrologists, clinical trialists, epidemiologists, economists, and other stakeholders to review current strategies for cardiovascular risk assessment in population studies in low-income and middle-income countries, their limitations, possible improvements, and future interests in screening programs. This report summarizes current evidence and presents highlights of unmet needs.
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Affiliation(s)
- Pietro A. Modesti
- Department of Clinical and Experimental Medicine, University of Florence, Florence
| | | | - Charles Agyemang
- Department of Public Health, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Sanjay Basu
- University of California, San Francisco, California, USA
| | - Athanase Benetos
- INSERM UMR S1116, Université de Lorraine, Vandoeuvre-les-Nancy, Nancy, France
| | - Francesco P. Cappuccio
- University of Warwick, Warwick Medical School, and University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
| | - Antonio Ceriello
- Institut d’Investigacions Biomèdiques August Pi i Sunyer IDIBAPS, and Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), Barcelona, Spain
| | - Stefano Del Prato
- Section of Metabolic Diseases and Diabetes, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Eoin O’Brien
- The Conway Institute, University College Dublin, Dublin, Ireland
| | | | | | | | | | - Giuseppe Remuzzi
- IRCCS-Istituto di Ricerche Farmacologiche ‘Mario Negri’, Bergamo, Italy
| | - David Stuckler
- Department of Sociology, University of Oxford, Oxford, UK
| | - Marc Twagirumukiza
- Faculty of Medicine and Health Sciences, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
| | - Luc M. Van Bortel
- Faculty of Medicine and Health Sciences, Heymans Institute of Pharmacology, Ghent University, Ghent, Belgium
| | | | - Dong Zhao
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Capital Medical University, Beijing Anzhen Hospital, Beijing, China
| | - Gianfranco Parati
- Department of Health Sciences, University of Milano-Bicocca
- Department of Cardiology, S. Luca Hospital, IRCCS Istituto Auxologico Italiano, Milan, Italy
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26
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Kondo M, Yamagata K, Hoshi SL, Saito C, Asahi K, Moriyama T, Tsuruya K, Konta T, Fujimoto S, Narita I, Kimura K, Iseki K, Watanabe T. Budget impact analysis of chronic kidney disease mass screening test in Japan. Clin Exp Nephrol 2014; 18:885-91. [PMID: 24515308 PMCID: PMC4271136 DOI: 10.1007/s10157-014-0943-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 01/15/2014] [Indexed: 01/18/2023]
Abstract
Background Our recently published cost-effectiveness study on chronic kidney disease mass screening test in Japan evaluated the use of dipstick test, serum creatinine (Cr) assay or both in specific health checkup (SHC). Mandating the use of serum Cr assay additionally, or the continuation of current policy mandating dipstick test only was found cost-effective. This study aims to examine the affordability of previously suggested reforms. Methods Budget impact analysis was conducted assuming the economic model would be good for 15 years and applying a population projection. Costs expended by social insurers without discounting were counted as budgets. Results Annual budget impacts of mass screening compared with do-nothing scenario were calculated as ¥79–¥−1,067 million for dipstick test only, ¥2,505–¥9,235 million for serum Cr assay only and ¥2,517–¥9,251 million for the use of both during a 15-year period. Annual budget impacts associated with the reforms were calculated as ¥975–¥4,129 million for mandating serum Cr assay in addition to the currently used mandatory dipstick test, and ¥963–¥4,113 million for mandating serum Cr assay only and abandoning dipstick test. Conclusions Estimated values associated with the reform from ¥963–¥4,129 million per year over 15 years are considerable amounts of money under limited resources. The most impressive finding of this study is the decreasing additional expenditures in dipstick test only scenario. This suggests that current policy which mandates dipstick test only would contain medical care expenditure.
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Affiliation(s)
- Masahide Kondo
- Department of Health Care Policy and Health Economics, Faculty of Medicine, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8577, Japan,
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27
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Mohebi R, Bozorgmanesh M, Sheikholeslami F, Azizi F, Hadaegh F. Contribution of glomerular filtration rate to 10-year cardiovascular and mortality risk among hypertensive adults: Tehran lipid and glucose study. J Clin Hypertens (Greenwich) 2013; 15:350-8. [PMID: 23614851 PMCID: PMC8033924 DOI: 10.1111/jch.12083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2012] [Revised: 01/15/2013] [Accepted: 01/18/2013] [Indexed: 08/10/2024]
Abstract
The authors tested the hypotheses that (1) estimated glomerular filtration rate (eGFR) predicts cardiovascular disease (CVD) or mortality risk among hypertensive patients, (2) associations are curvilinear, and (3) diabetes modifies these associations. Data from a 10-year follow-up of 3179 hypertensive patients 18 years and older were analyzed. Measurements included eGFR and CVD risk factors, and outcomes were CVD and mortality. Cox models were developed to estimate the hazard ratios (HRs) for different endpoints for a 1-standard deviation (SD) increment in eGFR. The nonlinearity in associations was examined by cubic spline method. Mean (SD) age of the participants (59.0% women) was 56.3 (12.3) years. During follow-up (10-year), 629 incident cases of CVD (296 women) and 320 deaths (130 women) were documented. The incidence rate of different outcomes decreased across increasing eGFR quintiles. Among men, irrespective of their diabetes status, eGFR was inversely associated with risk of mortality. Among women, irrespective of their diabetes status, eGFR did not predict mortality. Neither among men nor among women did eGFR predict CVD or coronary heart disease. No evidence was found for nonlinearity in these associations. eGFR was independently associated with mortality among hypertensive men with or without diabetes. When information on traditional CVD risk factors was available, eGFR provided no additional predictive value for CVD.
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Affiliation(s)
- Reza Mohebi
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Mohammadreza Bozorgmanesh
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Farhad Sheikholeslami
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
| | - Fereidoun Azizi
- Endocrine Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine SciencesShahid Beheshti University of Medical SciencesTehranIran
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29
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Kam Tao Li P, Burdmann EA, Mehta RL. Acute kidney injury: Global health alert. J Nephropathol 2013; 2:90-7. [PMID: 24475433 DOI: 10.12860/jnp.2013.15] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 12/20/2012] [Indexed: 01/24/2023] Open
Abstract
Acute kidney injury (AKI) is increasingly prevalent in developing and developed countries and is associated with severe morbidity and mortality. Most etiologies of AKI can be prevented by interventions at the individual, community, regional and in-hospital levels. Effective measures must include community-wide efforts to increase an awareness of the devastating effects of AKI and provide guidance on preventive strategies, as well as early recognition and management. Efforts should be focused on minimizing causes of AKI, increasing awareness of the importance of serial measurements of serum creatinine in high risk patients, and documenting urine volume in acutely ill people to achieve early diagnosis; there is as yet no definitive role for alternative biomarkers. Protocols need to be developed to systematically manage prerenal conditions and specific infections. More accurate data about the true incidence and clinical impact of AKI will help to raise the importance of the disease in the community, increase awareness of AKI by governments, the public, general and family physicians and other health care professionals to help prevent the disease. Prevention is the key to avoid the heavy burden of mortality and morbidity associated with AKI.
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Affiliation(s)
- Philip Kam Tao Li
- Department of Medicine & Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong
| | - Emmanuel A Burdmann
- Department of Medicine, University of Sao Paulo Medical School, Sao Paulo, SP
| | - Ravindra L Mehta
- Department of Medicine, University of California San Diego, San Diego, CA, USA
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30
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Woo KT, Chan CM, Wong KS, Choong HL, Tan HK, Foo MWY, Anantharaman V, Lee EJC, Tan CC, Lee GSL, Yap HK, Tan HB, Chin YM, Lim CH. National Health Survey on the Prevalence of Urinary Abnormalities in the Population: then and now (1975 to 2012). ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n8p339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Introduction: This paper presents the results of a community survey on urinary abnormalities which covered 1/80th of the population of Singapore in 1975. These findings were compared with the data from the Singapore National Service Registrants in 1974 as well as data from a recent survey in Singapore and that of other Asian and Western countries. Materials and Methods: The study covered 18,000 persons aged 15 years and above, representing a sampling fraction of 1/80th of the population. A total of 16,808 respondents attended the fi eld examination centres, of whom 16,497 had their urine sample tested representing 92.7% of the sample population. Results: In the dipstick urine testing at the fi eld examination centres, 769 subjects (4.6%) were found to have urinary abnormalities. Two hundred and eighty-two (36.7%) of these 769 subjects were found to have urinary abnormalities based on urine microscopy constituting a prevalence of 1.71%. The prevalence of proteinuria was 0.63% and for both haematuria and proteinuria was 0.73%. The prevalence for hypertension was 0.43% and renal insufficiency was 0.1%. Discussion: The consensus is that routine screening for chronic kidney disease (CKD) in the general population is not cost effective as the yield is too low. Whilst, most studies showed that screening of the general population was not cost effective, it has been suggested that screening for targeted groups of subjects could help to identify certain risk groups who may benefit from early intervention to prevent or retard the progression of CKD. Conclusion: The prevalence of urinary abnormalities in Singapore has remained the same, now and three decades ago.
Key words: Chronic kidney disease, Proteinuria, Screening
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Matsuo S. [Chronic kidney disease (CKD)--recent progress. Topics: I. Concept and importance]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2012; 101:1236-1242. [PMID: 22693841 DOI: 10.2169/naika.101.1236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- Seiichi Matsuo
- Department of Nephrology, Nagoya University Graduate School of Medicine, Japan
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Teo BW, Demirjian S. World Kidney Day 2012: Renal Transplantation. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2012. [DOI: 10.47102/annals-acadmedsg.v41n3p96] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Boon Wee Teo
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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